November 12, 2013

Camel Owned By A MERS Patient Tests Positive For Coronavirus

The Middle East respiratory coronavirus (MERS-CoV), which has sickened more than 150 people since first being detected in September 2012, has now been positively identified in the first camel, according to the BBC. The animal had been owned by a person previously diagnosed with the SARS-like virus.

This confirmation follows an earlier study that linked camels to the virus. Researchers with the National Institute for Public Health and the Environment (RIVM) in The Netherlands discovered MERS antibodies in the dromedary species. However, at that time, it was unclear if the camels that tested positive for the antibodies were recently infected or not.

Despite a link between the camel and its owner, it still remains unclear if dromedaries are responsible for passing the disease on to humans. Because coronaviruses can cause respiratory infections in both humans and animals, it may be possible that the owner passed the virus to the camel.

While coronaviruses can be spread easily through small water droplets when a person coughs or sneezes, experts agree that the MERS form is not very contagious – if it were, there would be many more cases by now.

In the case of the camel and its owner, a confirmation of the same strain of MERS in the dromedary would strengthen suspicions that camels are the source of human infections. The camel was tested after a 43-year-old man from Jeddah became ill, and was laboratory-confirmed to have the virus after polymerase chain reaction testing, according to Ziad Memish, MD, Saudi Arabia’s deputy minister for public health, as cited by Canadian media and reported by CIDRAP’s Robert Roos.

Memish said that further investigation was ongoing on other animals on the man’s property that had been known to be sick.

Saudi Arabia’s Ministry of Health said it was working to isolate the virus and compare it to a sample from the 43-year-old man. If the two isolates are identical, "this would be a first scientific discovery worldwide, and a door to identify the source of the virus," MOH was quoted as saying by Roos.

While this is likely to be the first time a camel can be directly linked to the virus in humans, it is not the first report of the possibility of such a scenario.

In mid-October, a 61-year-old Qatari man who was laboratory-confirmed to have MERS was reportedly in contact with camels and a number of other farm animals prior to becoming sick. But after testing of the animals, no virus was detected.

Marion Koopmans, DVM, PhD, chief of virology at RIVM, who led the earlier investigation that discovered the MERS antibodies in no less than 15 camels in the Canary Islands and in all 50 tested in Oman, said it would be a significant development if the camel in the latest case is confirmed to have the same virus as its owner.

"However, more work is needed to clarify how people are getting infected, as so far, apparently, very few people have animal contact, so the question remains how this virus spreads and how humans are getting infected," she told Roos of CIDRAP.

The data on the infected camel should only take a few days to sequence and either be confirmed or denied, she added.

The 43-year-old man from Jeddah had become ill on Oct. 27 and was hospitalized on Nov. 3. That report came from the World Health Organization (WHO) on Nov. 11, which coincided with another laboratory-confirmed case in a 72-year-old man from Riyadh who had underlying medical conditions. That man became ill on Oct. 23 and has been hospitalized since Oct. 31.

A day earlier, the WHO reported a single additional lab-confirmed case of MERS in a 48-year-old man from Qatar who had underlying medical conditions. He became ill on Oct. 25 and was hospitalized on Oct. 31. He is currently in critical condition. Preliminary investigations reveal that he was a frequent visitor to animal barns, and it was clear that he had not traveled outside the country and had not had any reported contact with a previously lab-confirmed case of MERS-CoV.

Globally, since Sept. 2012, there have been a total of 154 lab-confirmed cases of infection from MERS-CoV, with 64 deaths.

The WHO has continuously monitored the global situation pertaining to MERS, and currently suggests no travel or trade restrictions with the Middle East.